What is the Cause of this Dysphagia?

A 60-year-old woman visited the hospital with nonprogressive mild esophageal dysphagia (without oropharyngeal transfer difficulties for solids) for 10 years. Her clinical examination and screening blood tests were normal.

She had no previous medical problems except for carrying the hepatitis B virus. She underwent an upper gastrointestinal endoscopy, which revealed external compression and extrinsic arterial pulsations of the upper esophagus posteriorly (FigureA).

A computed tomography scan showed a right-sided aortic arch and compression of the posterior wall of the upper part of the esophagus (FiguresB and C).

The volume-rendered reconstruction image showed anomalous origin of left common carotid artery from the ascending aorta and left subclavian artery originating from the diverticulum (FiguresD and E).

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About the Author

Dr. Kristine Novak is the science editor for Gastroenterology and Clinical Gastroenterology and Hepatology. She has worked as an editor at biomedical research journals and as a science writer for 15 years, covering advances in gastroenterology, hepatology, cancer, immunology, biotechnology, molecular genetics, and clinical trials. She has a PhD in cell biology and an interest in all areas of medical research.